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To: 8mmMauser
I have abundant experience with Living Wills and other advanced directives. When I was a resident at Sloan-Kettering in the 1970s, I was sort of "present at the creation" of the format, and I have read hundreds and hundreds of these documents in various roles since.

What is very important to understand is that most of these documents are executed by well people, increasingly by well people who are also young (or, they are drafted by healthy young people, which is almost the same thing).

There is little that healthy young people can imagine that is worse than helplessness and disability. For this reason, they (almost) universally voice the notion, "I would rather be dead than live like that".

Of course, the situation of the mortally ill is quite different.

Everyone praises heaven, but no one wants to go there - at least not today.

Therefore, it is common (80+%) for persons who are able to cancel their "advanced directive" when their death is staring them in the face, and to elect aggressive treatment, regardless of the burdens or chance of success.

There are exceptions to this rule, mostly those involving chronic and invariably fatal diseases with a well-defined course.

Of course, the reason that insurance companies and the government have glommed on to living wills has nothing to do with autonomy - they want to kill sick people before they spend any money on them.

It is not unlikely, therefore, that interested third parties - mostly the government, but also greedy relatives and HMOs, will try to create a precedent where "living wills" can be enforced against the wishes of the patient - claiming that illness has rendered them incapable of "true" consent.

72 posted on 11/06/2005 4:30:03 PM PST by Jim Noble (Non, je ne regrette rien)
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To: Jim Noble

The precedents are already being set. Not only can they be enforced against the wishes of the patient, the provisions of the directive don't even need to be met. All that needs to happen is to incapacitate the patient with drugs and then take over.


73 posted on 11/07/2005 2:21:16 AM PST by DadsGirl ("Come to Me all who are weary and heavy laden, and I will give you rest." Jesus Christ)
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To: Jim Noble

You hit it! People change as they grow older and more often than not so do their ideas on many things!


74 posted on 11/07/2005 4:18:43 AM PST by tutstar (OurFlorida.true.ws)
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To: Jim Noble
Thanks for your insight.

8mm

moi non plus

75 posted on 11/07/2005 4:50:49 AM PST by 8mmMauser (Jesu ufam tobie..Jesus I trust in Thee)
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To: Jim Noble; floriduh voter; All
I thought you may be interested in this news item just out a few hours ago and appearing in this morning's Philadelphia Inquirer. (excerpted)

After three decades of urging Americans to write living wills, many doctors, lawyers and ethicists concede that these documents have largely failed.

The problems are many: Most people don't complete living wills. When they do, too often the paper isn't available when decisions about life support must be made.

Living wills, intended to ensure that patients' wishes are honored when they can't speak for themselves, rarely address the actual situations that arise. And many people don't really know in advance what treatments they would or wouldn't want.

"The 30 years of literature on living wills has shown very disappointing results," said Charles Sabatino, assistant director of the American Bar Association's Commission on Law and Aging. "The shortcomings of living wills are real. Dying is just too complicated."

Living wills not keeping promise

8mm

80 posted on 11/07/2005 5:31:26 AM PST by 8mmMauser (Jesu ufam tobie..Jesus I trust in Thee)
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